Barbiturates

Many sedatives, including chloroform, chloral hydrate and paraldehyde, were introduced into medicine in the nineteenth century, but the next, really significant turn was the discovery of barbiturates in 1862. The first barbiturate was opened in the laboratories of Bauer in Munich. Barbiturates were found among many other substances in the urine, and many believe that Bauer named them after a woman named Barbara who provided urine samples (Barbara’s urates, Barbiturates). Others claim that the drug got its name from the day it was opened, that is, St. Barbara’s Day. We will never know this for sure, but anyway, now the class of drugs called barbiturates has more than two thousand different compounds (although today only about fifty drugs are used predominantly for medical purposes). Since a very large number of barbiturates are still open, usually their common and specific names end with the suffix “-al”. Some typical barbiturates are presented in Table 7-1. The effects of the use of different barbiturates generally coincide, but they still differ in size and duration of action. Thus, pentobarbital and secobarbital are considered strong, fast-acting drugs (duration of action is two to four hours), while amobarbital is an intermediate-action drug (six to eight hours), and phenobarbital is a long-acting (eight to ten hours). Barbiturates, similar to benzodiazepines, act by slowing the transmission of nerve impulses, the mechanism of which will be discussed in this chapter. In general, barbiturates with instant exposure and short duration of action are used today as anesthetics (for example, pentobarbital), while barbiturates with delayed exposure and a long period of action are mainly used to treat epilepsy (for example, phenobarbital).

Barbiturates were first introduced to medical practice in 1903, when barbital was given the market name Veronal. Soon, the drug was often used as a sedative and as a first sleeping pill. The use of barbiturates in medicine increased until the 1960s, but decreased markedly in subsequent years. The rise and fall of the use of barbiturates had several reasons. Among the many ills known by humanity in the nineteenth century, insomnia and anxiety were the most frequent. Thus, any remedy for anxiety or promising sleep for insomnia suffered tremendous popularity and commercial success. Barbiturates did have the ability to induce sleep and to deal with anxiety – this explains their dominance in the market. Anyway, there is a certain number of problems associated with the use of barbiturates, which are discussed below, unknown to consumers and, most interestingly, to doctors. These problems have led to a decline in the use of barbiturates over the past twenty years.